Managing Special Enrollment Periods 

Open enrollment is a busy time for individuals with health insurance plans. Although the specific dates vary depending on the type of insurance, the state, and the employer, the overall process remains consistent. Open enrollment is the time when people can enroll in, update, change, or cancel their health insurance.  

Many individuals enroll in a health insurance plan through their employer, which reduces the financial burden of health care costs such as doctor’s visits, medications, and more. It’s important to note that you cannot make changes to your health insurance plan outside of the open enrollment period unless you qualify for a special enrollment period. 

Special Enrollment Periods 

Whether you’re an employer or an employee, it’s important to understand special enrollment periods and what they entail. 

Open enrollment is the only period for making changes to your health insurance. However, if you experience a qualifying life event, you can make these changes through a special enrollment period. Qualifying life events (QLE) are events that change your everyday life, such as getting married, losing your job, having a child, and more. QLEs include, but aren’t limited to the following:

• Getting married, divorced, or separated
• The death of a spouse or family member who shared your health plan
• Having or adopting a child
• Turning 26
• A change in employment, leading to the loss of coverage
• Moving your residence
• See a list of other QLEs 

While it is most common for people to qualify for a special enrollment period due to a QLE, several other situations may qualify someone for a special enrollment period. Such as: 

• Becoming a United States citizen
• Leaving incarceration
• Experiencing a natural disaster such as an earthquake, hurricane, etc.
• Learn more here 

Assistance with Managing Enrollment Periods

Open enrollment can already be a stressful and confusing time, but for employers, that stress can reach new heights. Managing different health insurance plans and costs can quickly become overwhelming, especially since all changes happen within that specific time frame. Employers also must be aware of employees who need to make health insurance changes during special enrollment periods and consistently review their current offerings to make the most cost-effective decision for their employees and company. Managing these changes is no easy feat, which is why business owners may look for assistance from a third-party company like Group Management Services (GMS).  

GMS helps business owners manage open and special enrollment periods with our expert guidance, the help of a Benefits Account Manager, access to competitive group health plans, and administrative benefit support. GMS also offers business owners access to supplemental benefits, effectively reducing the cost and headaches that come from benefits administration. Contact us to learn more about how GMS can help your company during open enrollment and assist in managing special enrollment periods.